Ask Jill
03.03.2017

Are Co-Pays Due At Time of Service?

Yes, the “co-pay” for specific medical care or treatment that has been established within your health insurance plan is typically due at the time that care or treatment is provided. A copayment for medical services is a strategy used within the pricing of health insurance plans to share the cost of the medical care patients receive between the insurer and the patient.

Being aware of what co-pay’s your coverage requires and how they relate to your deductible can help prevent any surprises as part of your visit to your physician, a hospital, or other medical provider. Co-pay amounts vary by health insurance plan. They can also vary by type of service being provided. As you choose among insurance plan options, you may find that some plan offerings have lower co-pays but higher deductibles or higher premiums. Finding the right balance of those expenses is a key part of choosing your insurance coverage as it can impact what you pay as part of your regular premium payment and what you are obligated to pay in a co-pay at the time you receive care.

The timing of co-pays being due at time of service comes out of efficiency for both the patient and the provider and helps reduce avoidable administrative expenses within the healthcare system (which is something that benefits all of us). When a co-pay is paid right at the time of service, it is quickly entered into the system as part of the registration process. It simplifies the process for everyone. It is attention to little things like this that have helped NMC achieve better efficiency and keep our charges to patients typically below average in the State and go forward with below average rate increases in typical years.

We appreciate your partnership in this effort. We have added a reminder about co-pays on our website and are building that into our other communications to help patients avoid being surprised. Our Financial staff is happy to answer questions about what their coverage requires of them for an upcoming visit. You can reach them by calling (802) 524-1006.

I understand that this is just one aspect of questions about insurance coverage and bills within healthcare. Our team is focused on helping you through this sometimes complex system. We continue to work on simplifying the process of billing. . We will work hard on your behalf to obtain the necessary referrals, authorizations, or pre-certifications from your health plan for your care. We will bill your health plan or other insurance (sometimes it is your automobile insurance or workers compensation) for covered services before billing you (for the amount that is not within your co-pay). We are committed to clear up any confusion you may have with a bill from the hospital or provider involved in your care. We apologize knowing that you may receive separate bills from the hospital and a provider if the provider is not a hospital employee.  Payment plans are available and financial assistance. We would be happy to discuss these options with you.  If you have questions about your bill, please call us. For questions about bills for hospital services, please call our Patient Financial Services team at (802) 524-1065. For questions about bills for care from physician practices employed by NMC, please call our Physician Account Services team at (802) 524-8949.

We understand that health insurance and healthcare financial systems are very complex and can be confusing. I hope this overview has been helpful and encourage you to reach out with your questions. Our team is here to help you and we want to exceed your expectations.

Your continued support is greatly appreciated.

— Jill Berry Bowen, NMC’s Chief Executive Officer